How can we leverage the ground breaking models being used in Africa for mobile health to bring low cost solutions to the US? The new Federal money could be used as seed money for low cost high impact solutions vs replacing private sector funds.

Patients, families, providers, employers, and payers are all rightly concerned about the issue of their and their constituents' privacy. Thirty years ago in a healthcare-reform and healthcare-IT-reform speech I gave at Harvard, I predicted that privacy would be the number one latent and patent issue sabataging these reforms. Some privavcy issues are legitimate. Some are bogus. How do we separate the wheat from the chaff? And once we have done that, how do we put in sufficient safeguards AND then successfully communicate that fact to all of the many different players to better enable acceptance and compliance and reduce terrorist attcks on the system?

Patients, families, providers, employers, and payers are all rightly concerned about the issue of their and their constituents' privacy. Thirty years ago in a healthcare-reform and healthcare-IT-reform speech I gave at Harvard, I predicted that privacy would be the number one latent and patent issue sabataging these reforms. Some privavcy issues are legitimate. Some are bogus. How do we separate the wheat from the chaff? And once we have done that, how do we put in sufficient safeguards AND then successfully communicate that fact to all of the many different players to better enable acceptance and compliance and reduce terrorist…

How can we best manage the natural tension between proprietary vs open source standards for the new healthcare-IT system? This tension, which could be a source of much needed creativity, has not been managed overly well in other sectors of the US and Global economies. Are there nonetheless good lessons to be learned from these earlier experiences? Best practices? Known evils and pittfalls?

When we face, as inevitably we will, domestic or even global shortages of supply of critical healthcare products or services, how will the de jure or de facto rationing burden be allocated among patient groups? Will politics (either Large "P" or small "p") or heritage or money rule? i.e., will "Might Make Right"? Or will we be able to count on the "Rule of Science" just like we now count on the "Rule of Law"? In good times, we have been pretty fair. Even poor people can get a heart or kidney transplant. But what will happen when hard times come? And will the increased demand of 70 MM newly or better insured patients put a "run" on supply just like we historically have had "runs" on banks? If so, who, when, and how will we decide? Will the FDA and the CMS play a role? Will they overly protect Medicare and Medicaid patients? Under-protect? Will we need new specialized courts for healthcare deliberations like we have for such specialties as Maritime and Bankruptcy?

When we face, as inevitably we will, domestic or even global shortages of supply of critical healthcare products or services, how will the de jure or de facto rationing burden be allocated among patient groups? Will politics (either Large "P" or small "p") or heritage or money rule? i.e., will "Might Make Right"? Or will we be able to count on the "Rule of Science" just like we now count on the "Rule of Law"? In good times, we have been pretty fair. Even poor people can get a heart or kidney transplant. But what will happen when hard times…

How will inevitable critical tradeoffs be made between such key macro competitors for funding as care spending vs infrastructure spending (especially infrastructure spending that will immediately and directly lower care costs)? Who will make these determinations, and when and where will they make them? What rules will govern their deliberations? Will the FDA and CMS play a role? Will the federal or state courts, other than as a last resort? Do we need a new court system like the Maritime Court or the Bankruptcy Court systems? What about inevitable critical tradeoffs between such key micro competitors for funding as surgical interventions vs watchful waiting vs drug interventions? Same additional questions. Bottom line--Who's Ox is going to get gored, it things go as now planned, and what can they do to stop being run over by the oncoming train?

How will inevitable critical tradeoffs be made between such key macro competitors for funding as care spending vs infrastructure spending (especially infrastructure spending that will immediately and directly lower care costs)? Who will make these determinations, and when and where will they make them? What rules will govern their deliberations? Will the FDA and CMS play a role? Will the federal or state courts, other than as a last resort? Do we need a new court system like the Maritime Court or the Bankruptcy Court systems? What about inevitable critical tradeoffs between such key micro competitors for funding as surgical…

By providing learning with competence assurance to all participants in the healthcare system --physician to patient -- we can increase health and wellness through prevention, get earlier diagnosis of treatable diseases like cancer, and improving the cost/performance equation to deal with The Healthcare Crisis. thewholesystem

How will the rising cost of dental treatment (non-cosmetic -- root canals, restorative,etc.) be addressed by the President's plan? Can technology help here or will medical tourism flourish even more in this area?

Behavioral Health care is an area that could really benefit from an investment of IT funds. BH providers lag behind general medicine in their use of HIT, in part because of lack of funding. Yet Behavioral health care accoutnts for a significant poriton of US health care spending, and depression is considered to be one of the top 5 disabilities. BH conditions also have high rates of comorbidity with other serious medical conditions, and BH consumers, especially children, would benefit immensely from the integration of care that is possible with improved HIT for BH providers along with other kinds of providers. Are there funds allocated specifically to Behavioral health in the stimulus plan? If not, are there mechanism by which BH providers and others can gain access to funding? -Thanks!

Behavioral Health care is an area that could really benefit from an investment of IT funds. BH providers lag behind general medicine in their use of HIT, in part because of lack of funding. Yet Behavioral health care accoutnts for a significant poriton of US health care spending, and depression is considered to be one of the top 5 disabilities. BH conditions also have high rates of comorbidity with other serious medical conditions, and BH consumers, especially children, would benefit immensely from the integration of care that is possible with improved HIT for BH providers along with other kinds of…

The recent economic stimulus bill provided $1.1 billion to create a council of up to 15 federal employees to coordinate comparative effectiveness research. How do you see this emphasis on comparative data changing the coverage and reimbursement of new treatments? Will this affect the data required for FDA approval? To what extent will comparative effectiveness research be utilized by health plans for coverage decisions?

+
I have been paralized for thirty years and is now facing the possibility of entering a nursing home. This is due to the fact that I take my health care very seriously and therefore, I ask many questons .This seems to intimadate and anger many people. I have my own home to live in, but my home state has ternimate my rights to the program that will assist me in paying for help allthough this would be cheaper than living in a nursing home or using home health agencies . Allegations made against me by different entities are for the most part false.My voice seems to be all but irrelevant.

+
I have been paralized for thirty years and is now facing the possibility of entering a nursing home. This is due to the fact that I take my health care very seriously and therefore, I ask many questons .This seems to intimadate and anger many people. I have my own home to live in, but my home state has ternimate my rights to the program that will assist me in paying for help allthough this would be cheaper than living in a nursing home or using home health agencies . Allegations made against me by different entities are for…

74% of Americans are online and 80% of them use the Internet for health searches, yet physicians often don't acknowledge this during a consultation. Could the sheets patients fill out on a clipboard before a visit include a question about concerns raised by any searches? Could doctors ask during a consultation? Should doctors recommend Web sites to patients, especially newly diagnosed ones? Finally, could such measures or others on the part of physicians help to increase patient health literacy skills?

We need to ensure that we are not just confirming the status quo by automating it. Many of our policies, procedures and even assumptions may be wrong. If we just focus on automation as opposed to structural change, we will just extend the life and consequences of our past mistakes. How do we avoid that??

Private FFS Medicare is gone. And Medicare Advantage healthplans, for the most part, have used risk adjusted funding fro profits rather than to get care to sick people. What happens to risk adjustment in Obama's plans?

Mega consumer sites like WedMD and Revolution Health do not appear to have a clear strategy here. It seems that health education should come from a patient's own affiliated health care provider -- and be a part of any electronic solution.